AB0422 THE EFFECTS OF CONCOMITANT USE OF METHOTREXATE IN PATIENTS WITH RHEUMATOID ARTHRITIS TREATED WITH SARILUMAB
Authors: S. Anno, T. Okano, K. Mandai, K. Orita, Y. Yamada, K. Mamoto, T. Iida, M. Tada, K. Inui, T. Koike, H. Nakamura
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Sarilumab was launched the second interleukin 6 receptor inhibitor (IL-6Ri) as a treatment for patients with rheumatoid arthritis (RA) in Japan. Tocilizumab, that was known as first IL-6Ri, showed excellent therapeutic effect without methotrexate (MTX) for RA. However, it was unknown that the effect on concomitant use of MTX in RA patients treated with sarilumab. <h3>Objectives</h3> We evaluated the effect on concomitant use of MTX in RA patients treated with sarilumab. <h3>Methods</h3> This study used a multicenter database included 673 RA patients treated with b/tsDMARDs. We finally analyzed 72 RA patients treated with sarilumab. Thirty-three RA patients were combined with MTX (MTX group) and 39 RA patients were not combined with MTX (non-MTX group). The continuation rate and efficacy at 52 weeks after sarilumab treatment in each group was evaluated. <h3>Results</h3> Non-MTX group was older, longer disease duration, and lower eGFR than MTX group (Table 1). The continuation rate at 52 weeks was not different between MTX group and non-MTX group (56.4 vs 74.4%, p=0.08). DAS28-CRP, SDAI, CDAI were decreased at 4, 12, 24, 36, 52 weeks after sarilumab treatment compared to baseline in both MTX group and non-MTX group (Figure 1). Improvement rate of DAS28-CRP, SDAI and CDAI at 4, 12, 24, 36, 52 weeks after sarilumab treatment were not different between groups (DAS28-CRP: p=0.36, p=0.53, p=0.56, p=0.46, p=0.29; SDAI: p=0.58, p=0.93, p=0.90, p=0.63, p=0.56; CDAI: p=0.65, p=0.98, p=0.99, p=0.61, p=0.47; respectively). HAQ was not improved in MTX group, but improved in non-MTX group during 52 weeks sarilumab treatment (MTX group, p=0.98; non-NTX group, p=0.04). In all patients, 49 RA patients were treated sarilumab as 2nd and more line biological/ targeted synthetic disease-modifying anti rheumatic dugs (b/tsDMARDs). DAS28-CRP, SDAI and CDAI at baseline in RA patients treated with sarilumab as 2nd and more line b/tsDMARDs were 4.1, 18.9, 16.4 in MTX group (n=23), and 4.6, 24.3, 22.6 in non-MTX group (n=26). DAS28-CRP, SDAI and CDAI were decreased at 4, 12, 24, 36, 52 weeks after sarilumab as 2nd and more line treatment compared to baseline in both MTX group (DAS28-CRP: 3.0, 2.5, 2.5, 2.7, 2.7, p&lt;0.01, respectively; SDAI: 12.5, 9.6, 9.3, 10.6, 10.3, p&lt;0.01, respectively; CDAI: 12.2, 9.4, 9.0, 10.2, 10.1, p&lt;0.01, respectively) and non-MTX group (DAS28-CRP: 3.3, 2.8, 2.8, 2.8, 2.6, p&lt;0.01, respectively; SDAI: 15.6, 11.5, 11.4, 11.1, 9.9, p&lt;0.01, respectively; CDAI: 15.2, 11.1, 11.1, 11.0, 9.7, p&lt;0.01, respectively). Improvement rate of DAS28-CRP, SDAI and CDAI at 4, 12, 24, 36, 52 weeks after sarilumab as 2nd and more line treatment were not different between groups (DAS28-CRP: p=0.99, p=0.96, p=0.83, p=0.94, p=0.53; SDAI: p=0.10, p=0.65, p=0.79, p=0.87, p=0.68; CDAI: p=0.95, p=0.72, p=0.76, p=0.74, p=0.53; respectively). <h3>Conclusion</h3> Sarilumab improved disease activity in patients with RA regardless of concomitant use of MTX. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.